Therapy for animals: Should chiropractors practice on the family pet, let alone hedgehogs and cockatoos?

Thomas Pfafman was a skeptic once, too.

Pfafman, a veterinarian, once thought chiropractic care done on animals was a scam, especially after he saw an untrained chiropractor injure a horse early in his career. But Pfafman eventually decided to get trained himself in animal chiropractic and became the 86th person in the world to be certified under the American Veterinary Chiropractic Association.

HB2215, sponsored by Rep. Warren Petersen, R-Gilbert, would allow chiropractors and veterinarians to be officially recognized as animal chiropractic practitioners under the State Board of Chiropractic Examiners or the State Veterinary Medical Examining Board.

The bill is one of more than 650 filed so far during the 2015 legislative session, ranging from a lottery game that would benefit veterans to a ban on hydraulic fracturing in the state, as well as numerous pieces of legislation related to child safety.

On the afternoon of Jan. 20, Pfafman held a chiropractic drop-in clinic at the Integrative Vet Med Center, where pet owners can bring in their animals, mostly dogs, for adjustments.

“It’s a very powerful therapy for animals, just like it is for people,” Pfafman said.

Though Pfafman is a veterinarian, he said both vets and traditional chiropractors, if properly trained and certified, should be allowed to practice on animals.

Pfafman’s postgraduate classes included chiropractors and veterinarians.  The vets knew animal anatomy and the chiropractors were experts in adjusting.

“The beautiful thing was watching the two professions come together,” Pfafman said.

The bill would require anyone practicing chiropractic on animals to complete postgraduate study at “an institution certified and approved by a nationally recognized organization in animal chiropractic.” Practitioners would already need to be a chiropractic doctor or veterinarian to fall under the bill’s guidelines.

Currently, according to the veterinary board, “only veterinarians should be working on providing chiropractic care in most situations. …  There’s differing opinions on that, coming from the chiropractors,” said Victoria Whitmore, executive director of the vet board.

A CEASE AND DESIST LETTER
The legislation came from the Arizona Association for Chiropractic, a group dedicated to promoting and expanding chiropractic care, after the vet board started sending cease and desist letters to chiropractors practicing on animals.

Barry Aarons, the association’s lobbyist, said, “There are a number of chiropractors, not a lot of them, around the state, mostly in rural areas, who for years have been getting these certifications and going ahead and doing chiropractic adjustments.”

He said the goal of HB2215 is to codify what exists now and make it clear that chiropractors and veterinarians, provided they have post-graduate education and certification, can practice on animals.

“The glitch has been, all of the sudden veterinarians have said, we don’t want you touching animals without a referral from a vet,” Aarons said.

Petersen got involved after one of his constituents was sent a cease and desist letter for practicing on animals as a chiropractor. He said it’s “somewhat of a turf war situation between the veterinarians and the chiropractors.”

But the bill would not be an added burden to practitioners, he said.

“This is clarifying that they have the right to practice on animals. It’s not a regulation, it’s a right. It’s just really codifying their rights,” Petersen said.

Petersen, who only has chickens and a bearded dragon, hasn’t used animal chiropractic services. He said HB 2215 would allow pet owners to choose which practitioner can best fit their needs.

“They’re restricting my ability to make choices. … I’m intelligent enough to make those decisions of who I want to use,” Petersen said.

The Veterinary Board of Examiners voted Jan. 21 to oppose the bill. Brian Serbin, the board’s chairman, said the group’s mission is to protect the health and welfare of animals and people.

“We felt that this bill would fly in the face of our mission. Lots of issues could arise from allowing chiropractors to work, without any supervision, on animals,” Serbin said.

The state’s veterinary statutes include manipulation similar to chiropractic care, Serbin said. There are already vets practicing, so he said the board didn’t see the need for chiropractors to be directly accessing animals.

“The concern is that, if the general public were to go directly to a chiropractor and they don’t have the skills, the knowledge, the experience to diagnose and treat, not only is that animal suffering but the public is at risk,” Serbin said.

BACK PAIN IN A DOG
Jim Maciulla, president-elect of the Arizona Veterinary Medical Association, said there are reasons chiropractors have to consult with vets before working on animals.

“As written, we have real concerns of animal health and public safety and feel that veterinarians should be involved in some part of the process,” Maciulla said.

For instance, back pain in a dog may not be a problem that could be solved by chiropractic adjusting – it may be Valley Fever or an orthopedic disease, he said.

“There’s a litany of diseases that involve the spine, and there’s a litany of both diagnostics or therapeutics that may or may not be relevant,” Maciulla said.

Since vets are trained in anatomy, they’re best suited to understand clinical signs that animals present and diagnose treatments from there, he said.

“Our patients don’t talk to us, so we need to know a lot of clinical signs, and there’s an art and skill in that. A chiropractor’s patients tell them what hurts, how long it hurts,” Maciulla said.

Though he said the association’s board hasn’t taken an official stance, there are concerns with the legislation. But the group is willing to play ball with chiropractors and come up with something that’s mutually agreeable, he said.

“We’re not going to squelch the whole concept,” Maciulla said.

In order to get certified by the American Veterinary Chiropractic Association, veterinarians or chiropractors must complete about 200 hours of training and pass a written and practical exam that includes adjustments on dogs and horses, according to the association’s handbook. Practitioners are required to get recertified every three years and meet continuing education requirements.

Aarons, the lobbyist, said the post-grad training is sufficient for either vets or chiropractors to do animal chiropractic, and it’s a waste of time and money to require a pet owner to get a referral from a vet for their animal to get treated.

“It’s not like one of these weekend, slam bam thank you ma’am kind of courses. … Why should they have to spend the extra money to go to a vet just so the vet can say, ‘Yeah, go to a chiropractor’?” Aarons said.

Julie Mayer, a veterinarian in Scottsdale who practices animal chiropractic, acupuncture and rehab, said she likes the idea behind the bill, but wants to make sure there’s some veterinary referral.

“I think it’s great, but I think it needs a lot of work. It needs a lot of cleaning up basically. Some words are too vague,” Mayer said.

The term “animal” is pretty vague, she said. Training focuses on horses, dogs and cats, but Mayer said she’s adjusted everything from hedgehogs to cockatoos and even an iguana.

“I really don’t think a doctor of chiropractic knows how many vertebrae are in the neck of a cockatoo,” Mayer said.

The best situation for animals and their owners is an integrated model that includes vets, chiropractors, physical therapists, massage therapists and anyone else who could help animals, she said. But there still should be a veterinarian involved to diagnose issues and refer to animal chiropractors first, rather than allowing chiropractors to have direct access to patients, Mayer said. She’s seen problems where vets didn’t see animals first and it harmed the patient.

“You’re not a diagnostician in that essence. You are with the spine, but you aren’t with diseases. There’s some things that can definitely get missed,” she said.

She said the groups and associations and boards should come together to figure out the best language for the bill to make sure everyone is protected and able to practice.

“We don’t need to fight. We don’t need to make this a boundary and owning a profession. We should all work together,” Mayer said.